Mr. Peter Ainsworth (East Surrey): I listened with interest to the previous debate about the problems of the health service in Birmingham. I have secured a debate on an issue that affects far fewer people, but is none the less creating acute anxiety in my constituency. I am grateful for the opportunity to return to the subject of Oxted and Limpsfield War Memorial hospital, which was last debated in the House on 1 July 1998, although I very much regret the need to raise the matter again.
The Minister will no doubt have read her brief on the issue, and will be aware of the hospital's history. She will be aware that it was the last war memorial hospital built in England, and that it was established by means of public subscription. The plaque at the entrance to the hospital was inscribed:
If the situation was bleak three years ago, it is now grim. This is a story of broken deadlines, broken promises and broken hopes. Let me remind the Under-Secretary of what the then Minister of State said on 1 July 1998. He said:
"I am advised that officials at the South East Regional Office of the NHS Executive are working closely with the Trust to ensure that the full business case for the new development should be received by June. It is anticipated that building work on the new site would hopefully start before the end of this year." Is the Minister still confident that a business case will be put in place by June? When does she think that the trust will be in a position to sign a contract with a nursing home partner? Will the Under-Secretary confirm that she remains hopeful that the building work on the new hospital will start this year? Will she give a categoric assurance that the Government remain committed to a replacement hospital in Oxted? That question must be asked because, as the Under-Secretary will know, the worst fears of many were confirmed on 6 February when the chief executive of the Surrey and Sussex Healthcare NHS trust suddenly announced that the hospital was to close without consultation. The reasons given were dilapidation and the safety of staff and patients. It was known eight years ago that the buildings were in poor repair. For eight years, local people have worried that, without major refurbishment or redevelopment, they would be left with nothing. I have to tell the Minister that the nothing option is not remotely acceptable to my constituents, who look to the Government to fulfil the promises that have been made.
Without doubt, the appalling finances of the trust have been made worse by the extraordinary decision, announced a few weeks ago, to suspend the proposed merger of health services provided at Crawley and Redhill. It is difficult not to regard that decision, which is contrary to clinical advice and financial common sense, as anything other than a political scam. I will not go into that today, but I mention it because it places a further unexpected burden on an NHS trust that is already saddled with mounting debts, unacceptable waiting times and obligations that it is struggling to meet.
If the trust did itself no favours by announcing the closure in the absence of any positive news about the hospital's future, it compounded its reputation for poor judgment by attempting, against advice, to hold a public meeting to discuss its decision in the hospital building. Nothing could better illustrate how the trust so completely underestimated the passions that the plight
From that moment on, the 'meeting' degenerated into what could be termed farce if the subject had not been so important. Chaos, disarray, turmoil, confusion--anything short of an actual riot--are just some of the words I use to describe the scene."
"The time scale and detail of the re-provision depend crucially...on the planning decisions taken by Tandridge district council. The local authority will no doubt be mindful of the need for a rapid decision to allay the concerns of local people about the future of health services in the town."--[Official Report, 1 July 1998; Vol. 315, c. 336.] That last sentence seems like an attempt to shift the burden of responsibility on to Tandridge district council, but before the council can determine a planning application, it must receive it. Tandridge councillors have waited and waited to be given an opportunity to determine a planning application for a new hospital facility in Oxted, but none has been forthcoming. The leader of Tandridge district council, Councillor Gordon
It is most unwelcome that the decision to close the hospital was taken prior to the outcome of the ombudsman's report. One of the issues raised by the Save Oxted Hospital action group could usefully benefit from an answer from the Minister today. It is suggested that, as a private hospital, Oxted and Limpsfield War Memorial hospital was not subject to the National Health Service Act 1946. It is further stated that, under the terms of its 1939 constitution, the hospital board was required to vote on any change of ownership but that no such vote ever took place. Can the Minister give an assurance today that the NHS has not just closed a hospital to which it had no legal title? It is obviously vital that the issue is cleared up before any further action.
It is no exaggeration to say that, although it had long been feared, the sudden closure of Oxted and Limpsfield War Memorial hospital came as a terrible shock to the whole community. Today it stands empty and boarded up: a tragic emblem of broken promises and a symbol of the failure of the Government's health policies in east Surrey. The Minister has been good enough to reply to written questions on the subject of security but I hope that she will take the opportunity, first, to state that responsibility for the physical security of the building rests with the NHS alone and, secondly, to detail the specific measures that are being taken to protect it from vandalism.
The significance of the hospital's closure and the importance attached to the future provision of replacement facilities in Oxted were evidenced by the huge attendance at a meeting held at Oxted county school on 10 March this year. More than 800 people came to what was probably the largest public gathering ever held in the town. I have already raised many of the questions that were left unanswered at that meeting, but two more remain. Immediately prior to its closure, Oxted and Limpsfield War Memorial hospital held 17 patients. Even if the redevelopment plans go ahead, under the plans there is provision for only 10 NHS beds
The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart) : I congratulate the hon. Member for East Surrey (Mr. Ainsworth) on securing this afternoon's debate on Oxted and Limpsfield War Memorial hospital. He has raised the topic with my right hon. Friend the Secretary of State for Health and me in correspondence and parliamentary questions during the past few months. He also referred to an Adjournment debate from three years ago. I do not think that anything that I say today will come as a big surprise.
Of course, I acknowledge the strong local feeling about the future of Oxted community hospital and recognise the frustration caused by the time that the development of the new facility has taken. The people of Oxted were promised a new health facility by summer 2001, but it has not materialised. I share the disappointment of the hon. Gentleman and his constituents that progress has not been made as swiftly as anticipated. However, I assure hon. Members that Surrey and Sussex Healthcare NHS trust and East Surrey health authority, supported by the south-east regional office of the NHS executive, are committed to providing new facilities and fully implementing the re-provision of services in their area. The hon. Gentleman asked me for what he called a categoric assurance and I will give him that today--there is no question of any manoeuvring to stop that happening. Unfortunate circumstances have combined to delay progress, but we are fully committed to going ahead.
Ms Stuart : I hope that, as I continue, the hon. Gentleman will understand why making such an offer would be a brave decision, as civil servants would describe it, and why it might not be possible to be so precise.
The hon. Gentleman will also note that the Government have set a challenging agenda for the NHS, one which will turn the NHS of old into a truly modern service. The NHS plan, which was published in July last year, set out the most fundamental and far-reaching programme of reform in its history. That 10-year plan aims to improve every aspect of the NHS--a reliable service that provides effective health care services and has patients' interests at its heart.
For the current financial year 2001-02, East Surrey health authority received nearly £290 million, which represents a 50 per cent. cash increase on the allocation of three years ago. The Surrey and Sussex Healthcare NHS trust has also benefited from specific capital investments--£200,000 to modernise the accident and emergency department, which was completed in March 2001, £700,000 to provide a major extension to the day surgery unit, and £150,000 to re-provide the child development centre. It is not that we do not believe in community hospitals. The Government are committed to making appropriate and effective use of such hospitals. We recognise the strength of feeling that people have for their local community hospitals and the value of those hospitals as part of the community that they serve.
The NHS plan announced that £900 million would be made available annually by 2003-04 for new intermediate care and related services to promote independence and improve quality of care for older people, of which around £255 million is to be earmarked specifically for NHS investment in intermediate care. We also pledged that, by 2004, there would be 5,000 extra intermediate care beds. Some of those will undoubtedly be in community hospitals, some in existing facilities and some in new developments.
I remind the House of the context for the changes in health services at the Oxted and Limpsfield community hospital. The re-provision of services at that hospital was consulted on, as the hon. Gentleman already knows, by East Surrey health authority during March 1997. The main drivers for that change were that the buildings were in a poor state of repair and suffering from subsidence. It was more cost effective and more appropriate for modern health care to look at building alternative facilities in Oxted rather than to attempt to upgrade the building.
The hon. Gentleman also referred to some of the issues raised in relation to the ownership of the hospital. The advice that the Department of Health received from the legal advisers was that Oxted hospital was transferred under the National Health Service Act 1946 and section 6(1) of that Act provides that voluntary hospitals shall be transferred to, and vested in, Ministers on the appointed day--the day the Act came into force in 1948. The interests in the property, where held by a governing body or by trustees, would pass to the Ministers free of any trusts. Furthermore, the re-provision of an in-patient facility as an out-patient facility is within the Secretary of State's functions and in keeping with the objects for which the property was used immediately before 1948. We are acting on the best legal advice, although I will not go into the finer points. The models of health care were changing and I am sure that the hon. Gentleman is aware that, as part of the original consultation, the number of beds was increased in the final plan from six to 10.
The proposed plans for Oxted reflected advice on safe medical practice and the changing nature of health care. They ensure that appropriate services, such as out-patients, therapies and nursing home beds, remain locally based and that more acute in-patient services shift to acute hospitals. The outcome of the consultation resulted in a decision to provide a new hospital to be built on land next to the existing hospital site. That will provide the same range of out-patient, diagnostic and therapy services as is currently available, but with the advantage of purpose-built modern accommodation. Furthermore, 10 in-patient beds are to be purchased from a private nursing home provider in the local community.
For a number of reasons, between 1997 and late 1998, the progress with developing a new scheme was relatively slow, as a number of local issues had to be debated and resolved before detailed work could begin. Those included the need to agree land development issues with the local council as well as agreeing the most appropriate option to deliver the preferred health care facilities. At the time of the last Adjournment debate, the anticipated time scale for completion of the project was July 2001. Although there had been some progress towards that target, a number of factors have meant that the project has suffered further delays.
An outline business case was approved at the end of 1999, a preferred bidder has been selected and negotiations have been under way with that private sector provider for some time. Notwithstanding the ombudsman's investigation, which I shall address in a moment, the trust is seeking to ensure that its proposed new build scheme represents best value for money to the NHS, and thereby the taxpayer.
As the hon. Gentleman stated, the trust recently had to close Oxted community hospital. That was partly due to the recent severe and prolonged rainfall. The fabric of the old hospital building has suffered a sudden and marked deterioration to such an extent that a safe environment for staff and patients could no longer be ensured. Representatives from the south-east regional office of the NHS executive visited the hospital on 6 February 2001 to ascertain the state of the building. Reports were received that examined in detail the building conditions, the impact on health and safety and
I am aware that, at a public meeting chaired by the hon. Gentleman, the trust declared its intention to close the hospital, and restated the commitment of both the health authority and the trust to deliver new health care facilities as soon as possible. Following closure, the trust and the health authority were able to take immediate steps to ensure that local health services were sustained. The majority of in-patients at the time of closure were either discharged or relocated to social services long-term care, a neighbouring community hospital or to the local acute hospital.
Out-patient services were relocated to spare capacity within the Oxted GP surgery and I am advised that it is working well. Any patients subsequently requiring care are referred to a local nursing home, the neighbouring community hospital or, if they require closer supervision, East Surrey hospital.
The hon. Gentleman referred to the ombudsman, who is investigating a complaint against the south-east regional office. It relates to the administration of the consultation process about the re-provision of services at Oxted hospital back in 1997. The complaint was formally notified to the then Permanent Secretary on 12 June 2000, and the inquiry has subsequently been in progress. I am advised that the NHS executive has complied fully with all the ombudsman's requests for information and will continue to co-operate fully.
The ombudsman has yet to report his findings. The hon. Gentleman will appreciate that, because of the substance of this complaint, the trust will have to await the outcome of the investigation before proceeding with the permanent closure of the hospital and the provision of new facilities. It is inappropriate for me to comment further, pending the outcome of the investigation.
There is, of course, a need to respect the memory and history of the old War Memorial hospital and I would not wish to diminish its importance. The artefacts of memorabilia have already been secured from the closed buildings and safely removed to the care of local GPs. The trust will continue to work with GPs and the local community to establish the best way to make this memorabilia safe in the long term and to ensure that it is accessible to local residents.
The hon. Gentleman also inquired about the physical security of the building. Following consultation with the local police and crime prevention officer, I can assure him that measures to ensure the external and internal security of the building have been taken. I understand that a representative of the trust will be meeting the crime prevention officer tomorrow at the old hospital to confirm that the measures taken are satisfactory. In addition, rubble will be installed in the driveway on Thursday to prevent vehicles being taken on to the site, which has also been insured against fire risks.
I recognise that the hon. Gentleman and his constituents are frustrated by the length of time that it is taking to develop a new facility. He will not be surprised to hear that I share some of that frustration, but I should like to reassure him and his constituents that that all parties are working together to ensure that the new health care facilities are provided as swiftly as possible. The hon. Gentleman will appreciate, however, that no contractual arrangements can be entered into or commitments given to a private sector provider until the outcome of the investigation by the ombudsman is known.
In the meantime, we are ensuring that the necessary frameworks are in place to allow us to make progress, once the investigation is over, as quickly as possible. I have instructed the regional office to monitor the position closely and to report developments regularly. Once the ombudsman has reported, I would welcome the opportunity to discuss subsequent steps with the hon. Gentleman. When the decision has been taken, it is crucial to move forward as quickly as possible. I hope that we can bring this unhappy tale to a conclusion that will, although late in the day, both allow new hospital provision and retain the memory of the War Memorial hospital. In the end, we want to serve the hon. Gentleman's constituents and all patients as best we can, and that is a shared objective.